<!DOCTYPE html>
<html>

	<head>
		<meta charset="utf-8" />
		<title>纯悦</title>

		<meta name="viewport" content="initial-scale=1,maximum-scale=1, minimum-scale=1">

		<script type="text/javascript">
			document.documentElement.style.fontSize = document.documentElement.clientWidth / 750 * 100 + 'px';
		</script>

		<link rel="stylesheet" type="text/css" href="css/common.css" />
	</head>

	<body class="lottery">
		<div class="pop_bg"></div>
		<div class="pop_box" id="formSubmit">
			<div class="pop_title">信息提交成功</div>
			<img src="img/pop_qrcode.png" width="100%" />
			<p>关注“可口可乐乐在上海”</p>
			<p>微信公众号，惊喜不错过~</p>
		</div>

		<div class="page">
			<img src="img/form_bg.jpg" width="100%" />
			<img class="form_title" src="img/form_title.png" width="100%" />
			<div class="form_box">
				<div class="input_box">
					<input type="text" name="name" placeholder="填写姓名" />
				</div>
				<div class="input_box">
					<input type="text" name="phone" placeholder="填写手机号码" />
				</div>
				<div class="input_box">
					<input type="text" name="yzm" placeholder="填写验证码" />
					<button>获取验证码</button>
				</div>
				<div class="flex_between">
					<div class="input_box select">
						<input type="text" name="province" id="province_text" placeholder="所在省份" />
						<select name="" id="province_select">
							<option value="" style="display: none;" selected="selected">aaa</option>
							<option value="">bbb</option>
							<option value="">ccc</option>
						</select>
					</div>
					<div class="input_box select">
						<input type="text" name="city" id="city_text" placeholder="所在城/区" />
						<select name="" id="city_select">
							<option value="" style="display: none;" selected="selected">aaa</option>
							<option value="">bbb</option>
							<option value="">ccc</option>
						</select>
					</div>
				</div>
				<div class="input_box">
					<input type="text" name="add" placeholder="填写详细收货地址" />
				</div>
				<button id="submit">提交信息</button>
			</div>
		</div>

		<script src="js/jquery-2.1.0.js" type="text/javascript" charset="utf-8"></script>
		<script type="text/javascript">
			$('#province_select').change(function(e) {
				$('#province_text').val($(this).find('option:selected').html());
			})

			$('#city_select').change(function(e) {
				$('#city_text').val($(this).find('option:selected').html());
			})
			
			$('#submit').click(function(e){
				$('.pop_bg').show();
				$('#formSubmit').show();
			})
		</script>
	</body>

</html>